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Episodes of participation per individual and percentage of individuals reporting conflicts of interest (COIs). The data points represents the percentage of individuals reporting a COI in a given cohort of individuals with the same number of episodes of participation.
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Mendelson TB, Meltzer M, Campbell EG, Caplan AL, Kirkpatrick JN. Conflicts of Interest in Cardiovascular Clinical Practice Guidelines. Arch Intern Med. 2011;171(6):577–584. doi:10.1001/archinternmed.2011.96
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Clinical practice guidelines (CPGs) serve as standards of care in practice, quality improvement, and reimbursement. The extent of conflicts of interest (COIs) in cardiology guideline production has not been well studied. Herein, we describe the scope of COIs in CPGs.
We examined the 17 most recent American College of Cardiology/American Heart Association guidelines through 2008. Using disclosure lists, we cataloged COIs for each participant as receiving a research grant, being on a speaker's bureau and/or receiving honoraria, owning stock, or being a consultant or member of an advisory board. We also cataloged the companies and institutions reported in each disclosure. "Episode" describes 1 instance of participation in 1 guideline by 1 person. "Individual" describes 1 person who may be involved in multiple episodes. "Company" describes a commercial or industry affiliation reported by an individual in a single episode. Analysis involved descriptive statistics and correlation analyses (Pearson correlation coefficient, χ2 and R2).
Fifty-six percent of the 498 individuals reported a COI, corresponding to 56% of the 651 episodes. Being a consultant or member of an advisory board was the most common type. The percentage of episodes involving a COI varied between guidelines (range, 13%-87%). The number of episodes per individual was associated with both presence and number of disclosures (P < .001 for both comparisons). Of 478 companies, the number per guideline ranged from 2 to 242 companies (mean, 38 companies). One company was the most frequently reported company in 7 of 17 guidelines.
Conflicts of interest are prevalent in cardiology guidelines, but there seems to be a significant number of experienced experts without COIs.
Clinical practice guidelines (CPGs) have become a fixture in clinical medicine. Though individual clinical trials have meaningful impacts on patient care, CPGs are often adopted as the standard of care and taught as such in training programs at all levels. CPGs also play a prominent role in quality improvement initiatives.1,2 In addition, CPGs have an emerging role in national policy to guide reimbursement and serve as the standard of care in medical malpractice cases.3
Although conflicts of interest (COIs) are found in all spheres of medicine4,5 their role in the formation of CPGs may be especially significant. Improper bias in the CPG production process can have a potentially more widespread adverse effect on patient care than individual practitioners' COIs. Charges of undue industry influence surround official recommendations in recent guidelines.6,7 A review of authors' industry links and published opinions also highlights this issue.8 Such situations can lead to an erosion of trust in guidelines. A recent Institute of Medicine report9 on COIs in medical research, education, and practice highlights the fact that the scope of COIs in CPGs has not been well studied. Nonetheless, the American College of Cardiology (ACC) and the American Heart Association (AHA) have recently placed restrictions on official participation in educational events and guidelines production in line with the Council of Medical Specialty Societies (CMSS) code for interactions with companies.10-12
We reviewed the ACC/AHA joint guidelines for this study. The most recent CPGs from the ACC/AHA include documented disclosures of COI, explicitly list the companies and institutions involved in each COI for each author and reviewer, categorize the COIs by type into at least 4 categories (receipt of research grant; receipt of honoraria or being on a speaker's bureau [honoraria/speaker's bureau]; owning stock or having other type of ownership [stock/other ownership]; or being a consultant or member of an advisory board [consultant/advisory board]), and indicate whether the COI is moderate or significant in magnitude (defined as ≤$10 000 or >$10 000, respectively).
The study was approved by the local institutional review board. Using the National Guideline Clearinghouse Web site (http://www.guideline.gov/), we cataloged disclosures from the most recent versions of the ACC/AHA guidelines through 2008. There were 2 "focused updates" of guidelines in 2009 but no official new guidelines or formal guideline revisions. The ACC and AHA officially adopted the CMSS code recommendations in 2010, which presumably introduced changes to the guideline process. Of the 19 available guidelines or the full revision updates, 2 guidelines13,14 did not include a list of disclosed COIs. We used the remaining 17 guidelines for our analysis.15-31
We use the term "episode" to describe 1 instance of participation in the production process of 1 guideline by 1 person. We use the term "individual" to mean 1 person who may be involved in multiple different episodes in different guidelines. We characterized individuals as an author or reviewer and identified the individuals who served as first author, chair, or co-chair. We define "company" as a unique commercial industry affiliation reported by an individual in a single episode. If 2 companies merged in the time between the production of different guidelines (eg, the companies were involved separately in a guideline produced in 2004 but merged in 2005, and the merged company was involved in a guideline produced in 2006), we considered them to be 2 different companies before the merger and a third different company following the merger. We separated commercial companies from governmental and noncommercial entities (ie, National Institutes of Health, Veteran's Administration, charities). We use the term "COI" to mean 1 reported affiliation causing a COI by 1 individual participating in 1 guideline. Individuals may have reported COIs with multiple companies in the same episode. Companies may be reported by multiple different individuals in the same guideline.
We also cataloged the number of companies/institutions each individual listed in each of the 4 categories mentioned herein. For each guideline, we generated a list of unique companies/institutions and compiled a list for each category of COI within a guideline, including a count of the number of different individuals with which the company had been involved. For guidelines that included data to categorize the degree of COI, we recorded the number of modest and significant COIs. Data analysis consisted of descriptive statistics and correlation analyses (Pearson correlation coefficient, χ2 and R2).
In the 17 guidelines, we found 651 episodes of participation by 498 individuals. On average, each individual participated in 1.31 episodes (range, 1-7). A total of 277 of the 498 individuals (56%) reported a COI. Over half of the episodes (365 of 651 [56%]) involved a COI. The most common form of COI was consultant/advisory board, followed by research grant, honoraria/speakers' bureau, and stock/other ownership (Table 1). There was an association between episodes in which at least 1 COI was reported and individual guidelines (P < .001). The percentage ranged widely across guidelines, from 13% (2 of 15 episodes) to 87% (13 of 15 episodes).
Role as guideline committee member (vs peer reviewer) was associated with COI (63% vs 51%; P = .006), as was role as chair/co-chair/first author (81% vs 55%; P = .03). Only 105 of the 498 individuals (21%) were involved in 2 or more guidelines. The percentage of individuals reporting a COI was higher among individuals with more episodes of participation, and the number of episodes of participation was associated with both presence of COIs (P < .001) and number of COIs (P < .001) (Figure).
There were 510 unique commercial companies involved in the 17 guidelines, with a wide range in the number of companies reported to be involved in different guidelines (mean, 38 companies; range, 2-242 companies) (Table 2). In contrast, there were only 18 unique noncommercial organizations reported to be involved in COIs (Table 3). We identified the commercial company involved in the greatest number of COIs in each guideline. One specific company was reported by more individuals than any other company in 7 of the 17 guidelines (Table 4).
Of the guidelines we analyzed, 6 included information characterizing COIs as modest vs significant. In these guidelines, there were 232 episodes, of which 150 involved COIs. Modest COIs were reported in 125 of 232 episodes (54%), whereas significant COIs were reported in 68 of 232 episodes (29%).
The popular media and members of the US Congress have focused their attention on COIs among individual physicians and researchers and in individual clinical trials.32 There has been less focus on COIs among participants in the production of guidelines. CPGs play an important role in synthesizing information for clinicians, as well as increasing uniform practice to certain standards and avoiding the uncontrolled use of medications, procedures, and devices for unproven indications.33 As such, CPGs are often the vehicle through which clinical trial data are translated into clinical practice. National campaigns are urging the increased use of CPGs in everyday practice, including the AHA's "Get With the Guidelines" and the ACC's "Guidelines Applied in Practice."1,2 The patient safety/pay-for-performance/quality of care movements have also begun to incorporate CPGs into standards of care and reimbursement policies.3 Although not prevalent currently, CPGs do enter the legal realm in medical malpractice if they are considered standard of care.34,35
Several controversial episodes involving COIs in guideline production have surfaced in recent years. In 1 instance, a guideline published in a supplement of a leading cardiology journal by the Screening for Heart Attack Prevention and Education Task Force,36 composed of a number of prominent cardiologists, attracted considerable controversy when it was reported that the publication of the guideline was funded by a donation from a major pharmaceutical company, that the authors failed to fully disclose their financial relationships, and that the guideline was never peer reviewed.
Our finding that most episodes of guidelines participation involve COIs, and that most individuals involved in producing guidelines report COIs, is a cause for concern. These findings are a particular cause for concern given the fact that many of the newest ACC/AHA guideline recommendations are based more on expert opinion than on clinical trial data.37 However, our findings of the average number of companies (38) and the range of numbers of companies (2-242) reported per guideline are perhaps less salient than the finding that a few4 companies were most reported in multiple different guidelines, and that 1 company was most reported in 7 of 17 guidelines.
It has been asserted that guidelines rarely have an effect on clinical practice6; thus, COIs among guidelines committee members is of lesser importance. It has, indeed, been documented that CPGs are not immediately implemented as the standard of care for a variety of reasons.38 Concern over authors' bias was a small but nonetheless present factor. Leape et al39 found that evidence behind guideline recommendations plays a factor in adherence to guidelines, whereas credibility of source does not. However, credibility and trust are 2 central issues in clinical medicine, especially in light of data showing that Americans' public confidence in the medical profession has declined.40
There is a relatively recent trend toward increased disclosure in guidelines production. A study by Papanikolaou et al41 found that only 7 of 191 guidelines published in medical journals from 1979 to 1999 mentioned COIs, and all 7 were published in 1999. Most of the earlier ACC/AHA guidelines (and many current guidelines from other societies) mention that COIs are orally disclosed at guideline committee meetings. This type of disclosure allows other authors and representatives from the society to consider an individual's COIs; however, it does not extend the same opportunity to the guideline readers (the ones implementing the guideline). An international group published criteria for guidelines in the Appraisal of Guidelines for Research and Evaluation (AGREE) in 2003 and included a strong recommendation for disclosure of all relevant COIs.42 Another change toward increased disclosure involves filling out directive disclosure questionnaires with specific categories of COIs rather than general, open-ended disclosure statements.18,21 It is likely that questionnaires increase disclosure and standardization of definitions.43
While publishing the tables of disclosures theoretically gives the readers and reviewers of the guidelines the same opportunity to evaluate the potential for bias in the overall recommendations, scrutinizing several pages of COIs in small print at the end of the guideline or reading the transcript of discussion about a recommendation may not be a high priority for a busy clinician. Furthermore, transcripts of the meetings are not available, and which participant(s) advocated specific recommendations cannot be discerned.
In addition to disclosure, several strategies have been proposed to deal with COIs.44 Agencies that sponsor guidelines could mandate that guideline committee members have no COIs related to the guideline they are creating, as reflected in the newly adopted ACC/AHA regulations, which follow the CMSS code for interactions with companies.11 Among other regulations, the code prohibits direct company support of CPG development; requires publication of disclosures of all CPG panel members, advisors, and reviewers; requires that a majority of CPG panel members be free of COIs relevant to the CPG subject matter (including the chair); and requires the guideline sponsor to develop procedures for developing strategies that minimize the risk of actual and perceived bias of CPG panel members. The Institute of Medicine report on Conflicts of Interest in Medical Research, Education, and Practice, and the AGREE criteria involve similar recommendations.9,10,12,41 Another approach requires members to abstain from voting on issues related to their COIs while participating in the discussion.
It has been argued that excluding or limiting individuals with COIs is unrealistic because there simply are not enough experts without COIs.45 In 2002, Choudhry et al46 examined the relationship between guideline authors and the pharmaceutical industry by surveying the authors of guidelines for common adult diseases. In the 44 guidelines they analyzed, 100 of the authors replied to their survey (response rate, 52%), and of the authors who responded, 87% reported some type of relationship with the pharmaceutical industry.
Our study, however, found a much lower reported rate of COIs (56%). The discrepancy may relate to the fact that we reviewed more recent and cardiology-specific guidelines, that nonrespondents to the Choudhry et al46 survey (63% in the United States and 29% in Canada) included a higher percentage of those without COIs, and/or that a larger number of the guideline participants included in our sample did not report all COIs but just those pertinent to the specific guideline. We also found that serving as an actual guideline committee member was associated with COIs, whereas serving as a reviewer was not. We found the same for chair/co-chair or first author vs other participants. If guideline committee members and committee chairs are potentially more qualified than reviewers, it may be that the recent, more stringent ACC/AHA participation requirements on COIs will exclude qualified participants (especially the CMSS rule that the chair must be free of COIs). Regardless, our data suggest there is still a large pool of experienced and unconflicted guideline participants.
It has also been argued that relationships with industry may also bring a breadth of perspective and experience, especially if individuals have relationships with multiple different companies. Theoretically, these individuals may be less conflicted than those with fewer industry affiliations, although they may be just as biased toward recommending costly interventions over inexpensive therapies, watchful waiting, or supportive care. We found that individuals with more episodes of participation were more likely to report COIs. However, only a small number of individuals (21%) reported more than 2 episodes, and the average number of episodes per individual was low (1.3).
Most COIs in our study involved consultant/advisory board participation and research grants rather than the (theoretically) more conflicting COIs of stock ownership. A minority of the guidelines required individuals to provide dollar amounts or rate the COI as "modest" or "significant" (most often using the cutoff of $10 000). While providing more details about COIs may give a reader a better sense of how conflicted a guideline writer or reviewer may be, the actual degree to which any individual may be influenced by any specific type of COI (or even a specific dollar amount) is impossible to assess. Individuals whose research is funded by a company may be just as interested in the financial success of the company as an individual receiving stock dividends. Nonetheless, there may be a difference between receipt of research funding, which is often administered by a third party (such as a university) and subject to its oversight, and stock ownership or payments for consulting work or participation in a speakers' bureau. Furthermore, $10 000 of research funding is probably not very "significant" at all.
Finally, it is argued that the presence of COIs is not proof of bias. Individuals with a long history of working on guidelines and with industry may be well equipped to handle COIs and promote the best interests of clinical care over the interests of industry affiliations. It may even be preferable to include individuals who have access to the most up-to-date advancements through industry ties, especially in a rapidly advancing and technology-driven field such as cardiology. Otherwise, guidelines may quickly become out of date. Nonetheless, if guideline-producing agencies wish to avoid COIs among participants in the CPG production process, it may be advantageous to create a structured apprenticeship program in which clinicians and researchers with expertise or promise in certain clinical areas are taught how to produce guidelines and are kept "in the loop" of new developments. A requirement for this apprenticeship program could be avoidance or divestiture of COIs, or at least a training course on how to deal with COIs. Training CPG writers and reviewers may also streamline the CPG process and promote higher quality and more evidence-based recommendations.
We examined only 1 professional society's guidelines. There are at least 10 other types of agencies that produce guidelines besides professional societies and over 2455 different guidelines on the National Guideline Clearinghouse Web site. We included only recent guidelines that reported COIs. The COI data were all self-reported and were not (to our knowledge) verified. A recent article in this journal has called into question the validity of self-reported disclosures.47 It is clear from the COIs reported in our study that different individuals interpreted disclosure requirements differently. Some individuals disclosed relationships with government agencies and charity organizations, whereas 1 author disclosed that he or she "had multiple relationships with commercial entities that arise and are met as needed."25(pe616) Our data on companies are complicated by mergers that took place between the writings of different guidelines. These mergers also complicate the accurate disclosure of COIs. While we attempted to account for these mergers, we relied on the information provided by the guidelines participants, which may not have been up to date. Another limitation of our analysis is the inability to evaluate other types of COIs, such as investigator bias.48 For example, a guideline participant who performs research on cardiac magnetic resonance imaging (MRI), but has no financial COIs, may be biased toward recommending the use of cardiac MRI technology vs another imaging modality.
Finally, our study does not address the very important issue of the COIs of the professional societies that produce the guidelines, which often receive large donations from industry and rely on industry sponsorship and participation in scientific sessions.49 Future discussions concerning methods to decrease COIs in guideline production should also apply to professional societies. The ACC has recently adopted the 2010 CMSS code, which, among other things, directs societies to avoid company influence in guidelines development processes or the dissemination of guidelines documents and prohibits acceptance of donations from donors who expect to influence society programs or positions.11,12 It is unclear, however, whether these measures applied to the guidelines produced prior to adoption of the code.
In conclusion, CPGs play an increasingly influential role in the practice of medicine. COIs are prevalent but vary widely in recent ACC/AHA guidelines. Individuals with greater involvement in CPGs reported more COIs. Although restricting participation may prevent some qualified individuals from serving in the guidelines production process, we found that a large percentage of individuals with guidelines experience reported no disclosures, suggesting there is a substantial pool of potential guideline writers and reviewers without COIs.
Correspondence: James N. Kirkpatrick, MD, Cardiovascular Medicine Division, Department of Medicine, University of Pennsylvania, 3400 Spruce St, 9021 Gates Pavilion, Philadelphia, PA 19104 (firstname.lastname@example.com).
Accepted for Publication: December 17, 2010.
Author Contributions:Study concept and design: Mendelson, Meltzer, Caplan, and Kirkpatrick. Acquisition of data: Mendelson and Kirkpatrick. Analysis and interpretation of data: Mendelson, Meltzer, Campbell, and Kirkpatrick. Drafting of the manuscript: Mendelson. Critical revision of the manuscript for important intellectual content: Meltzer, Campbell, Caplan, and Kirkpatrick. Statistical analysis: Mendelson. Administrative, technical, and material support: Kirkpatrick. Study supervision: Caplan and Kirkpatrick.
Financial Disclosure: None reported.
Previous Presentation: This study was presented in abstract/poster format at the Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference; April 25, 2009; Washington, DC.
Additional Contributions: Joseph P. Tadduni, MSE, assisted in data acquisition.
This article was corrected for an error in Table 1 on April 12, 2011.


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Madhya Pradesh, July 10 (Compass Direct News) – About 50 Hindu extremists from the Rashtriya Swayamsevak Sangh and Bajrang Dal ( Youth Wing of the World Hindu Council) chanting, "Jai Shri Ram [Praise lord Ram]" barged into Beersheba Church and attacked pastor Kuldeep Daniel, his family and church on June 14 in Ratlam. The Global Council of Indian Christians reported that the extremists beat, punched and kicked the pastor, his wife, two children and brother and also verbally abused them. They also destroyed church musical instruments and took the pastor's books and his brother cell phone. The couple suffered minor injuries. The pastor filed a police complaint at Alkapuri police station, but no arrests had been made at press time.
Karnataka – Police on June 12 detained Christians on a false complaint of conversion by allurement at Renuka Lodge, Athishaya Colony, Krishnaraja Sagar. The Global Council of Indian Christians (GCIC) reported that a Church of Christ house church pastor, K. Nagaraj, had organized a fasting and prayer service on June 9-12 in which many pastors and other Christians had gathered. At 11 a.m. a Hindu extremist from the area identified only as Vaiaramudi led a mob of around 20 people into the lodge, making baseless allegations of bribing people to convert to Christianity. The extremists beat the Christians and took them to the police station, where they registered the complaint. Police allowed the injured Christians to obtain medical treatment but detained Pastor Nagaraj and his wife, Anusuya. With the intervention of GCIC, the couple was released at 11:45 p.m. without charges.
Andhra Pradesh – Police on June 7 arrested pastor David Raju on a baseless complaint of forceful conversion from Hindu extremists in Hyderabad. According to the Evangelical Fellowship of India, Pastor Raju was invited by local Christians in Mangalagiri to preach in their church. Upon his arrival, about 20 extremists gathered and began beating the pastor, accusing him of forceful conversion and distributing gospel tracts. The Hindu hardliners later dragged the pastor to a local police station, where he was detained for about eight hours. With help from local Christian leaders, the accused reached an agreement with the Hindu extremists in which the pastor was given permission to continue Christian meetings in the area and the Christians forgave the extremists.
Karnataka – Police on June 7 disrupted a Sunday worship service and closed an Apostolic Church in Davanagere, claiming that the church had an illegal license. The Global Council of Indian Christians reported that the village head and Hindu extremists had interrupted a prayer meeting conducted by pastor Prem Prasanth on May 29 and questioned him about permits for constructing a church building there. The pastor told them that he obtained the necessary permission from the village head, to which the official denied giving Christians any such permission, saying they were engaged in forcible conversion efforts. On May 31, the pastor received a notice cancelling the church license. Police subsequently disrupted the following Sunday worship meeting, ordering Christians to leave and locking up the church. The pastor appealed to police, who told him to take the matter up in the court. The church remained shut down at press time.
Assam – Hindu extremists from the Vishwa Hindu Parishad (World Hindu Council) on May 31 vandalized a Baptist church in Jorhat and threatened two Christian girls, 16-year-old Moromi Gogoi and Monica Gogoi, 18, daughters of a pastor who was arrested on May 8 by Assam police on false charges of forcible conversion. The Hindu hardliners also demanded 5,000 rupees (US$100) from the girls. A source reported that about 10 intolerant Hindus entered the church premises and broke the church's fence, walls, windows and doors, and they had threatened the two girls several times via mobile phone to stop their ministry or face dire consequence. Assam Valley Baptist Mission (AVBM) leaders took the matter to officials, refusing to meet the demands. An AVBM representative told Compass that calm had returned to the area as news spread that police were following up the matter.
Andhra Pradesh – Police detained Christians after Hindutva (Hindu nationalist) extremists falsely accused them of forcible conversion. The Global Council of Indian Christians (GCIC) reported that pastor S. David of Yesu Prarthana Mandiram (Jesus Christ Prayer House), in Shad Nagar, Mahaboob Nagar district, organized a Vacation Bible School on May 25-31 for nearly 75 children in Kammadanam village, Mahaboob Nagar district. On May 28, as two Christians identified only Narasimhalu and Ramesh were conducting classes, local extremists from the Hindu extremist Rashtriya Swayamsevak Sangh and Vishwa Hindu Parishad arrived and accused the Christians of forcibly converting village children. The extremists filed a complaint at Shad Nagar police station against Pastor David, Narasimhalu and Ramesh. Jey Prakash, GCIC regional coordinator, told Compass that police held the Christians until evening and released them without charges, but the Vacation Bible School was stopped immediately.
Madhya Pradesh – About 10 Hindu extremists from the Hindu extremist Rashtriya Swayamsevak Sangh attacked pastor Ramesh Mandevey, leaving him unconscious on May 24 in Dewas. The Global Council of Indian Christians reported that about 10 Hindu hardliners stopped the pastor as he was on his way back from visiting a Christian's home and assaulted him. Sustaining internal injuries, the pastor was hospitalized in a local hospital. Local Christian leaders filed a police complaint at Dewas police station, but no arrests have been made.
Assam – Police on May 8 arrested and beat pastor Tarun Gogoi for alleged forceful conversion, suspicion of having links with Naga rebel militants and receiving donations from them for construction of their church building in Jorhat, Guwahati. The Hindustan Times reported that the pastor was accused of carrying out religious conversions – which are legal in India – with the help of tribal Naga underground groups, and the administration ordered him to temporarily stop construction work on their church building. Hindu extremists had filed a complaint against the pastor of luring local people to Christianity by offering cash and gifts-in-kind. Area church leaders denied any involvement with underground groups and forceful conversions, and they demanded legal action from authorities against officers who mistreated Pastor Gogoi. The pastor was released on May 9 after church intervention. Temsu Wathi, president of Assam Valley Baptist Mission, told Compass that after an inquiry, local officials said there was no evidence of forceful conversion and allowed the Christians to resume the church construction.
Tamil Nadu – Hindu extremists in Krishnagiri attacked pastor Paul Chinnaswamy on May 6, seriously injuring him. The Global Council of Indian Christians reported that the intolerant Hindus assaulted Pastor Chinnaswamy near his church. Kicking and punching him, they struck his chest and jaw and broke two of his teeth. Local Christians rushed to the scene and took him to a nearby hospital. The pastor filed a police complaint at Uddinapally, and officers took the pastor to three areas to identify the attackers, but he was unable to identify anyone. No arrests had been made at press time.
Report from Compass Direct News

subset: commoncrawl


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Export 4 results:Author Title [ Type] Year
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2015. Macroecological Patterns of Resilience Inferred from a Multinational, Synchronized Experiment. Sustainability 7: 1142-1160.
Effects of water temperature on summer periphyton biomass in shallow lakes: a pan-European mesocosm experiment. Aquatic Sciences 77: 499-510.. 2015.
Effects of trophic status, water level and temperature on shallow lake metabolism and metabolic balance: A standardized pan-European mesocosm experiment. Limnology and Oceanography 64: 616-631.. 2019.


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Scroll Stencils : Set of three oriental scroll designs
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Situationist Contributor John T. Jost together with Irina Feygina and Rachel E. Goldsmith have recently completed a fascinating article examining the motivations behind some people's unwillingness to take climate change seriously. The article, titled "System Justification, the Denial of Global Warming, and the Possibility of 'System-Sanctioned Change'" will be published later this year in Personality and Social Psychology Bulletin. Here's the abstract.
* * *
Despite extensive evidence of climate change and environmental destruction, polls continue to reveal widespread denial and resistance to helping the environment. It is posited here that these responses are linked to the motivational tendency to defend and justify the societal status quo in the face of the threat posed by environmental problems. The present research finds that system justification tendencies are associated with greater denial of environmental realities and less commitment to pro-environmental action. Moreover, the effects of political conservatism, national identification, and gender on denial of environmental problems are explained by variability in system justification tendencies. However, this research finds that it is possible to eliminate the negative effect of system justification on environmentalism by encouraging people to regard pro-environmental change as patriotic and consistent with protecting the status quo (i.e., as a case of "system-sanctioned change"). Theoretical and practical implications of these findings are discussed.
* * *
For the NYU Alumni Magazine, Sharon Tregaskis and Jason Hollander recently wrote a piece, titled "Why We Put Environmental Time Bomb on the Backburner," in which she discusses that article. Here are some excerpts.
* * *
Imagine a mammoth meteor blazing toward Earth. When it will arrive and whether it will hit directly is debatable, but scientists are unanimous on one thing—it's coming. And they're trying desperately to motivate everyone to take action before it's too late.
While this scenario is science fiction, a similar danger—just as daunting and apocalyptic—is on the horizon. Researchers now almost universally believe that catastrophic climate change, caused primarily by carbon dioxide emissions, is more a matter of "when," rather than "if." NASA climate scientist James Hansen predicts that we have perhaps a decade to halt our runaway greenhouse gases, otherwise we will guarantee for our children a fundamentally different planet—one where sea ice no longer blankets the Arctic, where storms relentlessly buffet coastal communities, and conflicts over scarce fresh water and shifting climactic zones rock international relations. And yet global carbon emissions are rising at unprecedented rates, and Americans are expected to produce ever-greater volumes of carbon dioxide in coming years.
Our inaction, in part, boils down to how we think. As with the meteor hurtling in our direction from millions of miles away, the science for measuring climate change and its future effects is complicated, and so far most evidence comes from distant, barely habited places. We, and our leaders, are easily distracted by closer issues—war, terrorism, disease, race relations, economic distress. "People get motivated with near-term dangers, but this is different," says Tyler Volk (GSAS '82, '84), a biologist and core faculty member in NYU's new environmental studies program. "It's not like the Hudson River is suddenly full of mercury and everyone is threatened."
As individuals, we may not deny the mounting evidence of global climate change, but we do harbor an inherent desire to keep our minds on other things. In his 1974 Pulitzer prize-winning book The Denial of Death, social scientist Ernest Becker argued that "the essence of normality is the refusal of reality," echoing Freud who believed repression to be our natural self-protection. In order to tolerate all sorts of inequities, we will often support or rationalize the status quo even when it contradicts our own self-interest, says NYU social psychologist John Jost, who calls this phenomenon "system justification theory."
Last spring, Jost collaborated with graduate student Irina Feygina (GSAS '10) and Mount Sinai Hospital psychologist Rachel Goldsmith to investigate how system justification theory interacts with environmental attitudes. Among their findings: Most people who believe that society is generally fair are also skeptical about the forecasted climate crisis. "There are psychological obstacles to creating real, lasting change," Jost says, "in addition to all of the scientific, technical, economic, and political obstacles." Because of this, he notes, denial is far easier and more convenient than supporting a carbon tax, paying more for high-efficiency technology, or giving up cheap goods shipped through elaborate, fuel-guzzling supply chains.
Even so, denial is getting harder, as scientists gain an increasingly nuanced understanding of the mechanics—and the consequences—of climate change. . . .
* * *
This public conversation is slowly trickling up to policy makers. In April, a cadre of retired U.S. generals and admirals offered the chilling statement that climate change was a "a threat multiplier" for global security and the fight against terrorism, as it will further destabilize desperate regions in the Middle East, Africa, and Asia. Even George W. Bush, who rejected the Kyoto climate accord in 2001, for the first time acknowledged global climate change in last winter's State of the Union address. "The problem is, among other things, ideological," Jost says, "and it needs to be addressed at that level, as well as at other, more technological levels."
* * *
[T]he momentum seems to be growing, says philosopher and director of environmental studies Dale Jamieson, who sees a parallel between the climate campaign and the Civil Rights Movement or widespread efforts to enact smoking bans, where over time, a moral and personal imperative emerged. "There's no way of addressing this unless people come to see it as an ethical issue that changes what they see as right and wrong, how they live, and what kind of world they're going to leave to their children," says Jamieson, adding, "The question [remains] whether we're going to act, and whether it will be meaningful."
* * *
To read the entire essay, click here. To read a sample of related Situationist posts, see "John Jost Speaks about His Own Research," "The Situation of Climate Change," "Getting a Grip on Climate Change," "Juliet Schor, 'Colossal Failure: The Output Bias of Market Economies'," "Denial," "The Need for a Situationist Morality," "The Heat is On," "Captured Science," and Jeffrey Sachs on Our Situation – Part I, Part II, Part III, Part IV, and, particularly, Part V."


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The trial of Luke Chrisco, the alleged Boulder "potty peeper," has been pushed back yet again after the 31-year-old defendant changed attorneys for the third time since being arrested last year.
Chrisco — who is accused of hiding in a portable toilet at a Boulder yoga festival last year and spying on women through peepholes he created at locations around Boulder — had been scheduled to stand trial on Feb. 11, but had his trial date pushed back to March 11.
Matt Connell is now representing Chrisco, who is facing eight counts of second-degree burglary — all felonies — and two misdemeanor counts of unlawful sexual contact and criminal invasion after pleading not guilty in August.
Chrisco was arrested last summer a few days after a woman using a portable toilet at a Boulder yoga festival noticed something moving in the tank and then saw a feces-stained man emerge from the toilet and run away.
According to police and court records, Chrisco — who was arrested by Vail police in an unrelated incident — told Boulder and University of Colorado police that he hid in crawl spaces and bathrooms around Boulder, including at CU, Naropa University, the Department of Motor Vehicles office and a number of businesses, in order to watch women use the toilet.
Police later found physical modifications in many of the locations that matched Chrisco's descriptions of his hiding places.
Chrisco's case has seen numerous delays and lawyer changes since that time. Chrisco's first attorney, Jason Savela, asked that Chrisco undergo a competency hearing after Chrisco said he wanted to represent himself using a "common law" defense.
He ultimately was found competent by Judge Thomas Mulvahill, who appointed Curtis Ramsay as his attorney. Ramsay was then replaced by Beth Kelley before she was replaced by Connell.
Chrisco remains in custody at the Boulder County Jail on $250,000 bond.


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Bulldogs shut down Hurons
RUDYARD — Rudyard displayed some dominant pitching and cruised past Rogers City 4-0 and 13-3 in Straits Area Conference baseball games Tuesday.
The Bulldogs' Jake Harrison limited the Hurons to two hits, striking out nine and walking just two in the opening shutout.
Rudyard had a four-run fourth inning to break open a pitcher's duel. Luke Steikar led off the inning with a walk and scored on Harrison's double. Justin Kruger added an RBI single, Austin Trotter singled, and Conner Myers drove in two more runs with a single.
"Harrison was dominant," Rudyard coach Ron VanSloten said. "He gave up a swinging bunt hit and a bad hop ground ball single in going the distance."
The Bulldogs scored early and often in Game 2. Brady VanSloten paced the offense, going 3-for-3 with three RBIs, and scoring three runs. He also drew three walks and was 4-for-5 in the two games. Steikar was 3-for-4 with two RBIs, while Conner Myers was 2-for-2 in the second game.
VanSloten started on the mound, working four innings for the win. He struck out four and walked two. Travis Myers worked a scoreless fifth inning, allowing five hits, walking one and striking out one.
Rudyard is scheduled to play at Pickford tonight, and host the Soo Black Sox on Thursday.


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Claude Monet painted thirty different depictions of the Rouen Cathedrals between 1892 and 1894, ostensibly creating the concept of seriality in art. He intended the paintings to be shown as a group, and the repetition (and the nuance) emphasizes the artist's hand. Certainly that is apparent when you take in the five Rouen Cathedral paintings on view now (two of which, from the Museé d'Orsay, have never been on view in the U.S. before). The impact of seeing them together is powerful. Funny, then, that the longer I stayed, the more I wondered—which one did I like best?
Installation view of "Monet/Lichtenstein: Rouen Cathedrals"
Something about this exercise felt wrong. Monet is one of the greatest artists of all time, and his Rouen Cathedrals are among his best-loved. How can you choose? Then again, are you even supposed to choose? If the paintings are meant as a series, is it meaningful to choose one over the others? Well, yes—it's meaningful because it's personal. The longer I looked at the paintings, the more invested in their nuances I became… and the more I began to consider my own peccadillos.
The first painting, simply titled Rouen Cathedral, Façade (1894), seemed to me the most rugged. All of Monet's paintings have a textural quality to them, but to me it was most palpable here. The third painting, Rouen Cathedral, Portal and Tour Saint-Roman, Full Sun, is the starkest. The pure blue of the sky, the pale yellow façade, absent of the blues, purples, and oranges of the other paintings depicting the building in the early morning hours.
But it's number four, Rouen Cathedral, the Portal and Tour Saint-Romain, Morning Effect (1893), that I like most.
Claude Monet, Rouen Cathedral, the Portal and Tour Saint-Romain, 1893, Museé d'Orsay, Paris, France (Inv. RF2001), photo courtesy Réunion des Musées Nationaux by Thierry Le Mage/Art Resource, NY
Nothing against the other paintings, but it's settled. Why? What distinguished it in my mind? Perhaps it's that there are signs of life—a flock of birds clustered around the tower, just taken flight. On my first pass around the gallery I was looking up close, reflexively feeling that if the difference is in the details, one must get close. The top left corner looked to be smudged—I processed it as an error. Why would Monet place these erratic, dark divots in the sky? Only backing away did they reveal themselves to be birds. I sat on the bench in the gallery, about ten or twelve feet away, and stared longer. It was then my eyes went to the portal, detecting the orange of illumination from within—a detail that is absent from the Full Sun painting, and less clear amidst the sunlit glow of the other early morning paintings. The contrast between indoors and out was highest here. Someone was inside. The building was breathing.
Playing favorites among the parts at expense of the sum is arguably a fool's game. Nevertheless, there it was. "That's the one I'd take home," I thought to myself. Perhaps I liked this one best because, frankly, I'd spent the most time looking at it. The birds hooked me; I found a toehold in the painting, something that asked me to make sense of it—to discover its beauty rather than to passively accept that it was beautiful. I looked twice.
And then: "That's the one I'd take home." The words I'd just thought to myself were suddenly spoken aloud by a man not two feet away from me, speaking to his wife. I glanced over and caught him pointing to the Full Sun painting—my least favorite! Apparently the question I'd been wrestling with was not uncommon. I listened as he went on about the painting. Then he turned his eyes to the others and started to speak of their differences. "That one is also really great," he said of another. "Those are the two best." The more he considered his options, the more difficult it became. Standing before the paintings, he finally summed it up:
"If I could only take two home… I'd take three."
Me too. Maybe five.
Scott Tennent


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Activities and Culture
The Big Idea
Freeside is a non-profit Organization with a mission of developing innovation and creativity in Atlanta. All of the work in the space is done by volunteers.
We have a lot of people that want to help out at the space, and we also get a lot of requests for changes/enhancements to the space as well as for Classes, Events, Projects, and collaboration with other organizations. In order to organize these efforts, we decided to create teams to divide up the work into specialized areas.
We created 3 main teams to tackle important projects in the space and assigned two Directors to be responsible for each and serve as the major points of contact.
The Activities and Culture (AC) team
This team is dedicated to organizing events in the space, especially classes and projects. This team also organizes the Teacher's Lounge, where teachers and project managers at Freeside can gather to exchange ideas, collaborate, and help to increase the quantity and quality of classes at Freeside.
Points of Contact
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Update: 2:25 p.m. Monday: A video of John Ashbery's entertaining talk has been posted on the NBCC blog.
You might expect an anniversary party for a literary-critics' organization to resemble a wake now that so many book-review sections have folded or shrunk. But the mood was lively at the festivities that marked the 35th year of the National Book Critics Circle last night at the Jerome L. Greene Performance Space in downtown Manhattan.
I spoke at the event along with the poet John Ashbery, the novelist E. L. Doctorow and dozens of current and former NBCC board members. Ashbery, born nearly a half century before the critics' organization was founded, received the first NBCC Award for poetry in 1975 for his Self-Portrait in a Convex Mirror, which also won a Pulitzer Prize and National Book Award. And he set the tone of the anniversary celebration when he said: "It's great to be back here. Actually, it's great to be anywhere."
Ashbery praised the Rain Taxi Review of Books and offered it as partial evidence that serious criticism of poetry and other art forms exists amid the meltdown at newspapers. The NBCC has posted a brief news report on his speech on its blog. You'll find excerpts from other speakers' comments, including mine, in a separate post there. The full text of all the speeches is scheduled to appear soon the NBCC site.


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Mission Impawsible
On January 8-10 2016, I will be participating in the 2016 Walt Disney World Marathon Weekend as a member of Team ASPCA, a national fundraising and endurance training program. I am excited to be participating as a member of Team ASPCA and honored to be raising the awareness and the much needed funding to support the ASPCA's programs. Your donation will help the ASPCA provide life-saving programs and services to millions of animals nationwide. The ASPCA is very important to me and I appreciate your help as we fight to give abused and homeless animals a second chance at life. Please support me by making a donation and help me make a positive impact in the lives of animals! Thank you!
About the ASPCA: Fighting for animals is a 24/7 job, but your commitment makes it possible for our life-saving programs to create happy endings for those innocent lives touched by cruelty. Every single day of the year, we are rescuing animals from neglect and suffering. With your support, we are able to rescue animals from dog fighting, cockfighting, and puppy mills, work to end animal homelessness and farm animal cruelty, and provide medical care for countless pets in need. Please help us save even more animals and donate to this Team ASPCA campaign today.
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Chocolate Marble Cheesecake with Coconut, Lemongrass, and Kaffir Lime – 17 and Baking does Daring Bakers
April 27, 2009 at 12:00 am 135 comments
Dear Daring Bakers,
I love you. Seriously. Each and every one of you, from the very bottom of my heart. I've watched you grow, the blogroll getting longer and longer each month, and I've savored the challenges, looking at every elegant photograph and memorable post with admiration and just a touch of envy.
In complete honesty, Daring Bakers, you were out of my league. Perhaps I could make a food blog, but never could I make the same desserts as you – challenging, beautiful, time consuming, potentially expensive – it was not in the cards for an amateur 17 year old who fancied herself a foodie.
Lucky for me, Daring Bakers are the warmest, friendliest bakers around. I still can't quite believe that I am a Daring Baker now, and that I've finished my first challenge. Actually, this might be a daydream. I could potentially be in 5th period English. Don't wake me up.
Love, love, love
The April 2009 challenge is hosted by Jenny from Jenny Bakes. She has chosen Abbey's Infamous Cheesecake as the challenge.
After recovering from the wild crazy joy that was being accepted into the Daring Bakers, I went absolutely insane waiting for the April challenge to be announced. I won't lie – I felt scared that it would be a fancy French pastry that I would completely defile, and that would be the end of it. But I'd made cheesecake twice before – plain cheesecake – and was eager to try more exotic flavors and see how this recipe compared with mine.
I must have played with a dozen different ideas. A spicy Mexican Hot Chocolate cheesecake, green tea and white chocolate, blood orange and champagne, even basil. When I brainstormed aloud about coconut to my parents, my dad said "Thai." And it all came together.
Chocolate Marble Cheesecake with Coconut, Lemongrass, and Kaffir Lime.
And yeah, that tiny bite is what's left of the slice from the picture before.
I actually stopped the photoshoot to eat the cake I was photographing. Then I guiltily set down the plate and picked up the camera.
This cheesecake is just that good.
[8/4/10 Update – I made this cheesecake for the Seattle talk show New Day Northwest! Watch me make the cheesecake on TV here.]
It's a bit Asian inspired. Coconut, lemongrass, and especially kaffir lime are all characteristic flavors in Thai cooking. And the chocolate? You can't go wrong with that. It pairs really well with the coconut.
The flavor wasn't as strong as I'd expected, but it was lovely. The coconut is definitely the most prominent, it hits you after the first bite and says "Coconut." The lemongrass is more subtle. The lime is probably the faintest flavor, not something easily pinpointed but definitely tasted. The chocolate – well, chocolate is always divine. I didn't use too much because I was worried about overpowering the otherwise delicate flavor of the cheesecake, and I think I hit just the right balance.
This was a great cheesecake recipe. It was creamy, though not quite as heavy as the cheesecake I've made before. My mother, who doesn't care for anything richer than chiffon cake, proclaimed it one of her all time favorites. She was just as reluctant as I was to donate it to her office before we ate the whole thing.
It did crack, though this is probably my fault – I opened the springform pan way, way, way before the cheesecake was done. I also may have overmixed the batter, as I usually do it by hand but used a mixer this time, as per the instructions. I still think the cheesecake looks gorgeous. I didn't even cover it up with a ganache or fruit. I proudly displayed that crack along with the honey-golden edges and the mysterious chocolate swirls. No one complained.
Changes to the recipe: To add the Thai flavor, I used 1/2 cup heavy cream and 1/2 cup coconut cream rather than the full 1 cup heavy cream called for. I infused the creams with lemongrass and kaffir lime leaves, and used lime juice instead of lemon in the cheesecake too. I didn't want to buy coconut extract, so I used vanilla. I also didn't want to buy coconut or lime liquor, so I omitted the alcohol.
The crust combines the Thai and chocolate: crushed chocolate cookies, cocoa powder, and shredded coconut. I left out the sugar in the recipe because the coconut was sweetened.
As for the chocolate swirl, I simply melted bittersweet chocolate and mixed it into about 3/4 cup of the chocolate mixture. The cheesecake probably would have looked nicer with more chocolate swirls, but this ratio kept the coconut, lemongrass, and lime flavors more than an afterthought.
A big thank you to Jenny for hosting such a great challenge, as well as all of the daring bakers for their inspiration and friendliness. I really encourage you to check out everyone else's cheesecakes too. They're nothing short of amazing.
Chocolate Marble Cheesecake with Coconut, Lemongrass, and Kaffir Lime
Makes one 9″ cheesecake
10 whole chocolate graham crackers
4 oz (1 stick) butter, melted
2 tsp Dutch-processed cocoa powder
1/3 cup sweetened shredded coconut
1 tsp vanilla extract
1/2 cup heavy cream
1/2 cup coconut cream (not coconut milk or cream of coconut)
1 large stalk lemon grass, or 2 thin stalks lemon grass
2 dried kaffir lime leaves (can be bought at specialty Asian stores such as Uwajimaya)
3 (8 oz) containers of cream cheese, room temperature
1 cup sugar
3 large eggs, room temperature
1 tbsp lime juice
1 tbsp vanilla extract
2 oz bittersweet chocolate, melted and slightly cooled
Preheat the oven to 350 degrees F and begin to boil a large pot of water for the waterbath. Generously butter a 9″ springform pan. Wrap the outside of the pan in a extra-heavy duty aluminum foil.
Chop up the lemongrass stalk into inch sized pieces, breaking the layers apart and reserving the juices. Place in a small saucepan, along with the heavy cream, coconut cream, and dried kaffir lime leaves. Heat over medium-high heat until mixture boils, then remove from heat and cover. Let steep until cooled completely. Strain the cream into a small bowl and set aside. Discard the lemongrass and lime leaves.
Place the chocolate graham crackers in a large ziploc bag and close it so it's airtight. Roll a rolling pin over the bag, pressing down to crush the crackers into fine crumbs. You should end up with 2 cups of crumbs. Mix together the crust ingredients and press into the bottom of the springform pan. [I like to use a metal measuring cup with a flat bottom and straight sides to help pack the crust in.] Set the pan aside.
In the bowl of a stand-mixer (or in a large bowl if using a hand-mixer), beat the cream cheese for 30 seconds on low speed until creamy. Beat in the sugar and cream at a slow speed (about 3 on a Kitchen Aid) until smooth. Add eggs, one at a time, fully incorporating each before adding the next. Make sure to scrape down the bowl in between each egg. Add the infused cream mixture, vanilla extract, and lime juice and blend until just smooth and creamy, taking care not to overmix. [Some lumps are okay. The closer to room temperature your cream cheese is, the fewer lumps you'll get.]
Take 3/4 cup of the cream cheese mixture and mix it with the melted chocolate. Pour a third of the white batter into the prepared crust. Drop in half the chocolate batter in tablespoon sized dollops across the white batter. Smooth the remaining 2/3 of the white batter into the pan. Dollop tablespoons of the remaining 1/2 chocolate batter across the top. Run a sharp, thin knife or bamboo skewer through the batter for a swirled effect.
Tap the pan on the counter a few times to bring all air bubbles to the surface. Set the springform pan inside a larger pan, then pour the boiling water 1 inch deep between the larger pan and the foil. Don't pour the water between the springform pan and foil.
Bake 45 to 55 minutes, until it is almost done – this can be hard to judge, but you're looking for the cake to hold together, but still have a lot of jiggle to it in the center. You don't want it to be completely firm at this stage. [50 minutes is perfect for my oven.] Close the oven door, turn the heat off, and let rest in the cooling oven for one hour. This lets the cake finish cooking and cool down gently enough so that it won't crack on the top. After one hour, remove cheesecake from oven and lift carefully out of water bath. Let it finish cooling on the counter, and then cover and put in the fridge to chill. Once fully chilled, it is ready to serve.
Printer Friendly Version – Chocolate Marble Cheesecake with Coconut, Lemongrass, and Kaffir Lime
My first DB Challenge, ta-da! I can't wait for May!
Entry filed under: Cake/Cupcakes, Daring Bakers. Tags: cheesecake, chocolate, coconut, cream, cream cheese, creamy, Daring Bakers, lemongrass, lime.
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For more information, visit www.kbb.com. Kelley Blue Book is a registered trademark of Kelley Blue Book Co., Inc.
Pre-Owned 2019 AcuraRDX A-Spec Package SUV
- Exterior Color
- White Diamond Pearl
- Interior Color
- Red
- Odometer
- 38,518 miles
- Body/Seating
- SUV/5 seats
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- Drivetrain
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Acura RDX
Highlighted Features
- Navigation system
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- 1-touch down
- 1-touch up
- Adaptive Cruise Control
- Air conditioning
- Auto-dimming rearview mirror
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- Driver door bin
- Driver vanity mirror
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- Front seats: bucket
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- Power 4-way passenger lumbar support
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- Fuel economy combined: 24mpg
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- Manual-shift auto
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- Recommended fuel: Premium Unleaded
- Torque: 280 lb.-ft. @ 1,600RPM
- Transmission: 10 speed automatic
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- Ground clearance (min): 145mm (5.7")
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- Door mirrors: body-color
- Heated door mirrors
- Power door mirrors
- Power liftgate
- Rear cargo: power liftgate
- Spoiler
- Tailpipe finisher: chrome
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- Engine bore x stroke: 86.0mm x 85.9mm (3.39" x 3.38")
- Engine displacement: 2.0 L
- Engine horsepower: 272hp @ 6,500RPM
- Engine torque: 280 lb.-ft. @ 1,600RPM
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- Front shoulder room: 1,517mm (59.7")
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Dealer Notes
KBB.com Consumer Reviews
- 3.0
Would like to love this car, but I don't
By MNRDXBUYER on Saturday, August 17, 2019Car is exceptionally fine driver, but the infotainment system is a constant source of irritation due to several issues (30-45 seconds to first music after starting car) and freezing of the USB device every few days (have tried 3 different USB drives). Should have read more user reviews before buying.
- 5.0
2019 RDX Advance Superb
By Niala on Sunday, April 21, 2019I leased this vehicle after reeearching for six months and driving everything on the market In Honolulu. There's no other new 2019 SUV with the extras this vehicle has for the price and quality. Believe me I've driven everything out there. Classy,practical, economical and fun to drive. Nothing compares regarding storage space and the ride is WOW exciting. You've got everything you could ask for with exceptional affordability. Go get one!
- 5.0
Great all around value!
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New Arrivals
2017 Volkswagen Tiguan 2.0T S…
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Quick Specs
- Other Exterior
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2023 Nissan Sentra SV Sedan
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